An article , I stumbled upon recently discusses why American health care is in deep trouble. There is a huge variation in the health care costs across the country. The article goes on to reveal , a simple Appendicectomy can cost anywhere between 7500 to 1,70000 $ in different hospitals in USA. (In India it costs 1000 $ in any star hospital !)

The fundamental flaw is treatment being the same , it is delivered in such a fashion , the cost incurred is kept ridiculously high.

It is akin to comparing a 10 dollar lunch to a 1000 dollar feast , both ultimately fulfills a purpose , relive the hunger effectively

while , the later can damage the country’s economy in a variety of ways !

Car makers automate the industry with Robots to reduce the human labor and cost of a vehicle , while medical industry does the opposite . . . privileged few get their appendix removed with a help of metal hand !

Final message

Modern medicine must aim to improve the quality of care with a positive impact at a reasonable cost. In the name of cutting edge technologies , it should not raise the medical bill in a meaningless fashion .This is meager exploitation of human suffering.

It is hilarious to note certain medical Robots* are primarily made to assist surgeon for which no assistance is required at all ! (I heard a story about a Robot which responds to voice command and pass on a knife for cutting and a gauze for wiping ! What a great medical discovery !)

Disclaimer

* Of course Robots (Cyber knifes ) may have a role in some rare surgeries which require high precision cutting especially in Neuro , Vascular , oncological surgeries.

It is about how a bundle of human cells(organs) behave at times of adversity .

It is about how our mind takes on the body .

It is also about , how the care takers Heal/Manipulate /Manhandle these cells at times of distress !

We know, two persons with identical injuries , sustained in a car crash one dies within an hour , while the other with a many fold serious injury successfully fight the trauma and walk out of hospital with victorious .That is the fighting spirit .This is either inherited are nurtured or both.

This implies , an accidental injury may be an external , unpredictable event, while the response to that injury is predetermined or even a predictable response !

In the name of modern science , we “the human animals” are trying to buy this fighting spirit with money.We are made to believe , survival and well-being is a commodity and can be bought with high cost medicines , and high cost care .

Remember , one of the most astonishing medical fact is , while we may struggle to induce swine flu in a laboratory on a given individual ( Even if , H1Ni viral concentrate is infused or inhaled ) , an other person gets this disease , while simply flying over an infected country . Such is the complexity of the host response system in medicine .

So , it is foolish to think health can be bought or maintained with money power or modern hi-tech medical care .At best it can save few lives with its life supporting drugs and devices . Ultimately, human survival is determined by the way we live and the way our ancestors lived and how we fight the illness.

Yogi’s of Himalayas lived for more than 100 years without the need for drug eluting stents and LV assist devices .

Having totally misunderstood the concept of health and illness the world is wondering how on earth , we can reduce the escalating cost of healthy living (pseudo health !)

An article in the current NEJM ponders over , Why in Grand junction, Colorado ,USA , the health care cost is very much lower , without compromising the quality of life and survival.

The answer is very simple .There is some body in that county , who dares to think beyond raw science and adds little bit of common sense ! Obviously he has to be rewarded and this model need to be replicated elsewhere.

Pessimism, from the Latin pessimus (worst), is a state of mind which negatively colors the perception of life, especially with regard to future events.

Understanding pessimism is not that simple . Some people argue optimism represents a strong mind while a pessimism is the domain of the weak . But it is not necessarily true. Both pessimist and optimist are unreal , and playing the dangerous game of predicting the future. So realism is the answer .

In this era of information highways , commercial exploitation of science , our thought process is grossly determined by our perception of events.We hardly have an intention or time to analyse our thought process.

An optimist ( Rather , unregulated optimist ! ) is a person who welcomes any growth good or bad.*

A pessimist is a person who welcomes only good growth.*

So how to identify good growth ? That is the million dollar question!

Many of the optimists may not bother about the final outcome of a treatment *

A pessimist bothers only about that .

An optimist rarely asks questions, blindly accepts every thing !

A pessimist never believes any thing !

Actually the fundamental principle of scientific medicine lies in proving the null hypothesis null and void.Any treatment is useless until proved other wise . So pessimist can be argued to follow true science , while many of the hardcore optimists are blind believers ..

*It may be a harsh way of interpreting an optimist but uncontrolled optimism has played havoc in our patients like many of the failed treatments (Some of them released prematurely into patient domain has killed many lives . Power of positive thinking should be within the realms of scientific feasibility !

So in our journey to conquer human health , we may proceed with an optimistic mind and a pessimistic eyes !

This understanding is all the more important in this era of contaminated science .It is a well known fact , now last 50 years of planet earth has inflicted the maximum damage to ourselves than our ancestors did in 5000 years. That’s why we are compelled to meet at Copenhagen .(We never learn from our mistakes, that’s a different story !) .

There is definite and urgent need for world summit on cleansing the medical science from the clutches of commerce and ignorance . A medical green house effect, with dangerous holes in health care is imposing on us (Another pessimistic thought . . . of course in the interest of human kind !)

World health organization , a sleeping giant has to be awakened on this issue

Final message:

Mankind has evolved over many millenniums , probably with a sole purpose of living , that is reproduction and propagation of our genre without harming the environment and other species.

Unrestricted and unregulated growth of any kind is dangerous we call it as malignancy in pathology .In science , we tend to call it a” great future ”

Our sixth sense* has outgrown miserably out of reality , as have we decided to take on the nature and GOD .Now , many developing country men do not believe in death .They are fighting a losing battle against the God. And they suffer with escalating health costs of keeping the elderly , alive who are knocking at the doors of heaven or hell . The same countries, which deny funds for curable illnesses of the poor is a different story altogether !

The principle of modern medicine would ideally be

Reduce human suffering irrespective of economic status

Curing a illness if there is a cure

Prolonging life if there is useful purpose

Allow a good quality death if there is no cure.

Most importantly , prey to god give us strength and capacity to identify which is good and which is bad for our patients .

Read and learn for a complete guide on optimism and pessimism

* It is important to recognise , the same sixth sense has made it possible to share our views through a great tool of Internet . So we should not be against the growth of science but against the misuses and wrong interpretations of it .

Do 64slice MDCT in all patients who has a coronary event and follow it up with catheter based CAG.

Use liberally the new biochemical marker , serum B-naturetic peptide (BNP) to diagnose cardiac failure in lieu of basal auscultation.

Advice cardiac resynchronisation therapy in all patients who are in class 4 cardiac failure with a wide qrs complex .

As it is may be considered a crime to administer empirical heparin, do ventilation perfusion scan in all cases with suspected pulmonary embolism.

Do serial CPK MB and troponin levels in all patients with well established STEMI .

Open up all occluded coronary arteries irrespective of symptoms and muscle viability.

Consider ablation of pulmonary veins as an initial strategy in patients with recurrent idiopathic AF. If it is not feasible atleast occlude their left atrial appendage with watch man device.

Never tell your patients the truths about the diet , exercise & lifestyle modification (That can cure most of the early hypertension) . Instead encourage the use of newest ARBs or even try direct renin antoagonists to treat all those patients in stage 1 hypertension.

Avoid regular heparin in acute coronary syndromes as it is a disgrace to use it in today’s world. Replace all prescription of heparin with enoxaparine or still better , fondaparinux whenever possible.

Finally never discharge a heftily insured patient until he completes all the cardiology investigations that are available in your hospital .

Is he a person who puts a metal coil coated with a synthetic fungus in a incidentally detected block inside a small coronary artery and sends the bill to the Insurance company ?

Is he a person in a cosmopolitan hospital who opens up a chronically closed coronary artery , in an asymptomatic patient and live telecasts his achievement trans continentally ?

Is he a person who checks in by the early morning flight and puts multiple wires in an aged patient with class 3 heart failure and make him walk 20 meters extra at a cost of 1000$ / Meter ?

Is he a person living in Wall street , who looks for variety of holes In the heart and trying to occlude it with exotic devices

Is he the unknown physician who Intervenesin the natural history of Rheumatic heart disease and arrests immune mediated valve damage by giving the monthly injections penicillin in remote parts of our country ?

Is he the person who Intervenes to prevent young persons from smoking and help maintain their coronary endothelium enriched with nitric oxide & arrest the coronary epidemic ?

Is he the small town doctor who Intervenes to treat a breathless cardiac failure patient with digoxin and frusemide and dramatically alleviate the symptoms and prolong the life of our poor country men?

Is she the village health nurse from an inaccessible health centre located in a hilly terrain , Intervening successfully, by pulling out live babies from severely anemic pregnant mothers with failing hearts ?